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Folia Morphologica 2022The pathophysiology of migraines and headaches has been a point of interest in research as they affect a large subset of the population, and the exact mechanism is still... (Review)
Review
The pathophysiology of migraines and headaches has been a point of interest in research as they affect a large subset of the population, and the exact mechanism is still unclear. There is evidence implicating the dura mater and its innervation as contributing factors, especially at the posterior cranial fossa. Many modes of innervation have been identified, including the dorsal root ganglion, superior cervical ganglion, vagus nerve, trigeminal nerve, hypoglossal nerve, and glossopharyngeal nerve. While the exact method of innervation is still under investigation, there is strong evidence suggesting that different types of headaches (migraine vs. occipital vs. cervicogenic) are due to specific nerves and inflammatory mediators that contribute to the dura mater in some way. By understanding how these innervation patterns manifest clinically, the course of treatment can be tailored based on the physiological aetiology. Here, we present a comprehensive literature review of the current research regarding the innervation of the dura mater of the posterior cranial fossa and its clinical implications.
Topics: Humans; Dura Mater; Headache; Ganglia, Spinal; Cranial Fossa, Posterior
PubMed: 34730227
DOI: 10.5603/FM.a2021.0114 -
Neurology India 2022Hypertrophic pachymeningitis (HPM) is a unique disorder characterized by thickening and fibrosis of the dura mater. Clinically it presents with headache, cranial nerve... (Observational Study)
Observational Study
BACKGROUND
Hypertrophic pachymeningitis (HPM) is a unique disorder characterized by thickening and fibrosis of the dura mater. Clinically it presents with headache, cranial nerve palsies, and other focal neurological deficits. Two forms exist, one is primary, where all other causes have been excluded and the other is secondary where an identifiable cause exists. It is important to recognize these secondary causes as treatment depends on the etiology.
OBJECTIVE
To elucidate the various characteristics of HPM. To delineate clinical-radiological features that help differentiate secondary from primary causes and to understand treatment response and disease outcomes of HPM.
METHODS
This retrospective observational study included 33 patients who presented with radiological diagnosis of HPM from January 2014 to July 2019. Spontaneous intracranial hypotension patients were excluded. All patients were extensively evaluated for secondary causes and treatment outcomes were analyzed on follow-up.
RESULTS AND CONCLUSIONS
Secondary causes of HPM were present in 48% cases. The clue for primary causes is an associated Tolosa-Hunt syndrome. Secondary causes in our series are immunological, infection, and malignancy. Clues to differentiate primary from these secondary causes are clinical like myelopathy, seizures, poor response to immunosuppression; radiological like hypertrophic cranial nerves, infarcts, bony erosion, and leptomeningeal involvement. There are case reports in literature but large Indian studies are lacking. This manuscript presents a large cohort of cases with HPM, which helps differentiate primary from secondary causes, as management and prognosis depend on etiology. An algorithm depicting the approach to the management of HPM has been presented.
Topics: Humans; Magnetic Resonance Imaging; Meningitis; Cranial Nerve Diseases; Headache; Treatment Outcome; Hypertrophy; Dura Mater
PubMed: 36537427
DOI: 10.4103/0028-3886.364052 -
Interventional Neuroradiology : Journal... Dec 2015The arterial blood supply to the dura mater is rich, complex and is derived from both the internal and external carotid systems. Endovascular management of a variety of...
The arterial blood supply to the dura mater is rich, complex and is derived from both the internal and external carotid systems. Endovascular management of a variety of intracranial diseases necessitates a thorough understanding of the dural arterial network. In this article we review the normal contributions of the pial arteries to the blood supply of the dura mater and discuss some aspects of its role in the supply of dural arteriovenous shunts (DAVS).
Topics: Anatomic Landmarks; Dura Mater; Humans; Pia Mater; Reference Values
PubMed: 26494407
DOI: 10.1177/1591019915609137 -
Arquivos de Neuro-psiquiatria Dec 2022RNA extraction is a step that precedes several molecular techniques. The fibrous tissue, more specifically the dura mater, has several limitations in routine protocols,...
BACKGROUND
RNA extraction is a step that precedes several molecular techniques. The fibrous tissue, more specifically the dura mater, has several limitations in routine protocols, and lacks optimization protocols to overcome these problems.
OBJECTIVE
To test stock reagents and purification kits, optimizing commercial kit protocols for RNA extraction from the dura mater.
METHODS
Dura mater samples were obtained from eight Wistar rats and maintained in two different stabilizers. The samples were purified using four different protocols, and the RNA was evaluated for the yield and purity in NanoDrop 2000 (Thermo Scientific, Wilmington, DE, United States). Beta-actin gene was used for analyzing gene expression, since is one of the most used reference genes.
RESULTS
The RNA preservation was similar in both stabilizers. The addition of an incubation step prior the purification protocols allowed better tissue digestion and RNA recovery. The RNA purified using the protocols membrane-based showed higher quality than liquid-liquid purification. This impact was observed in the 3-week evaluation using RT-qPCR.
CONCLUSION
Stabilizers are efficient for RNA preservation and membrane-based purification protocols are more suitable for RNA recovery from dura mater tissue, allowing the evaluation of gene expression in this type of tissue. Adaptations in the dura mater RNA extraction protocol differ from the pre-established protocols because it takes into account the peculiarity of fibrous tissue and low cellularity. In addition to providing a low-cost mechanism, based on techniques that are part of the laboratory routine, it is possible to improve the quality of the extracted material, ensuring greater efficiency in the use of subsequent techniques.
Topics: Animals; Rats; Rats, Wistar; RNA; Dura Mater
PubMed: 36580958
DOI: 10.1055/s-0042-1758865 -
Stem Cell Reviews and Reports Dec 2022Patient-derived cells hold great promise for precision medicine approaches in human health. Human dermal fibroblasts have been a major source of cells for reprogramming...
Patient-derived cells hold great promise for precision medicine approaches in human health. Human dermal fibroblasts have been a major source of cells for reprogramming and differentiating into specific cell types for disease modeling. Postmortem human dura mater has been suggested as a primary source of fibroblasts for in vitro modeling of neurodegenerative diseases. Although fibroblast-like cells from human and mouse dura mater have been previously described, their utility for reprogramming and direct differentiation protocols has not been fully established. In this study, cells derived from postmortem dura mater are directly compared to those from dermal biopsies of living subjects. In two instances, we have isolated and compared dermal and dural cell lines from the same subject. Notably, striking differences were observed between cells of dermal and dural origin. Compared to dermal fibroblasts, postmortem dura mater-derived cells demonstrated different morphology, slower growth rates, and a higher rate of karyotype abnormality. Dura mater-derived cells also failed to express fibroblast protein markers. When dermal fibroblasts and dura mater-derived cells from the same subject were compared, they exhibited highly divergent gene expression profiles that suggest dura mater cells originated from a mixed mural lineage. Given their postmortem origin, somatic mutation signatures of dura mater-derived cells were assessed and suggest defective DNA damage repair. This study argues for rigorous karyotyping of postmortem derived cell lines and highlights limitations of postmortem human dura mater-derived cells for modeling normal biology or disease-associated pathobiology.
Topics: Humans; Animals; Mice; Transcriptome; Dura Mater; Cell Differentiation; Fibroblasts; Cells, Cultured
PubMed: 35809166
DOI: 10.1007/s12015-022-10416-x -
Turkish Neurosurgery 2023To present the configuration of the tentorial venous sinuses, and to determine the optimal incision zone on the tentorium cerebelli.
AIM
To present the configuration of the tentorial venous sinuses, and to determine the optimal incision zone on the tentorium cerebelli.
MATERIAL AND METHODS
This study has been completed with 24 autopsied cadavers. For every cadaver, firstly, supratentorial tissues were removed and tentorial measurements were noted, superior part of the tentorial sinuses was captured, and then infratentorial tissues were removed, and all the sinuses were checked and captured.
RESULTS
Average age of the studied 24 fresh cadavers was 50 years, wherein 4 were females and 20 were males. Tentorial sinus was presented in 87% of the cases, with 45% medial, 33% lateral, and 22% in the middle third of each tentorium half.
CONCLUSION
This study showed the pattern, incidence, location, and distribution of tentorial venous sinuses and tried to find the optimum incision zone by identifying sparse areas for the venous sinuses during transtentorial surgical approaches.
Topics: Male; Female; Humans; Middle Aged; Cranial Sinuses; Dura Mater; Cadaver; Surgical Wound; Head
PubMed: 36482851
DOI: 10.5137/1019-5149.JTN.37725-22.5 -
Acta Biomaterialia Oct 2023Biomechanical experiments help link tissue morphology with load-deformation characteristics. A tissue-dependent minimum sample number is indispensable to obtain accurate...
Biomechanical experiments help link tissue morphology with load-deformation characteristics. A tissue-dependent minimum sample number is indispensable to obtain accurate material properties. Stress-strain properties were retrieved from human dura mater and scalp skin, exemplifying two distinct soft tissues. Minimum sample sizes necessary for a stable estimation of material properties were obtained in a simulation study. One-thousand random samples were sequentially drawn for calculating the point at which a majority of the estimators settled within a corridor of stability at given tolerance levels around a 'complete' reference for the mean, median and coefficient of variation. Stable estimations of means and medians can be achieved below sample sizes of 30 at a ± 20%-tolerance within 80%-conformity for scalp skin and dura. Lower tolerance levels or higher conformity dramatically increase the required sample size. Conformity was barely ever reached for the coefficient of variation. The parameter type appears decisive for achieving conformity. STATEMENT OF SIGNIFICANCE: Biomechanical trials utilizing human tissues are needed to obtain material properties for surgical repair, tissue engineering and modeling purposes. Linking tissue mechanics with morphology helps elucidate form-function relationships, the 'morpho-mechanical link'. For material properties to be accurate, it is vital to examine a minimum number of samples. This number may vary between tissues, and the effects of intrinsic tissue characteristics on data accuracy are unclear to date. This study used data obtained from human dura and skin to compute minimum sample sizes required for estimating material properties at a stable level. It was shown that stable estimations are possible at a ± 20%-tolerance within 80%-conformity below sample sizes of 30. Higher accuracy warrants much higher sample sizes for most material properties.
Topics: Humans; Biomechanical Phenomena; Sample Size; Skin; Dura Mater
PubMed: 37517620
DOI: 10.1016/j.actbio.2023.07.036 -
PloS One 2023The cornea and cranial dura mater share sensory innervation. This link raises the possibility that pathological impulses mediated by corneal injury may be transmitted to...
The cornea and cranial dura mater share sensory innervation. This link raises the possibility that pathological impulses mediated by corneal injury may be transmitted to the cranial dura, trigger dural perivascular/connective tissue nociceptor responses, and induce vascular and stromal alterations affecting dura mater blood and lymphatic vessel functionality. In this study, using a mouse model, we demonstrate for the first time that two weeks after the initial insult, alkaline injury to the cornea leads to remote pathological changes within the coronal suture area of the dura mater. Specifically, we detected significant pro-fibrotic changes in the dural stroma, as well as vascular remodeling characterized by alterations in vascular smooth muscle cell (VSMC) morphology, reduced blood vessel VSMC coverage, endothelial cell expression of the fibroblast specific protein 1, and significant increase in the number of podoplanin-positive lymphatic sprouts. Intriguingly, the deficiency of a major extracellular matrix component, small leucine-rich proteoglycan decorin, modifies both the direction and the extent of these changes. As the dura mater is the most important route for the brain metabolic clearance, these results are of clinical relevance and provide a much-needed link explaining the association between ophthalmic conditions and the development of neurodegenerative diseases.
Topics: Humans; Cranial Sutures; Skull; Connective Tissue; Dura Mater; Corneal Injuries
PubMed: 37079653
DOI: 10.1371/journal.pone.0284082 -
Comparative Medicine Apr 2020The biocompatibility, biodegradation, feasibility, and efficacy of medical devices like dural sealants and substitutes are often evaluated in various animal models....
The biocompatibility, biodegradation, feasibility, and efficacy of medical devices like dural sealants and substitutes are often evaluated in various animal models. However, none of these studies explain the rationale for choosing a particular species, and a systematic interspecies comparison of the dura is not available. We hypothesized that histologic characteristics of the dura would differ among species. We systematically investigated basic characteristics of the dura, including thickness, composition, and fibroblast orientation of the dura mater, in 34 samples representing 10 animal species and compared these features with human dura by using hematoxylin and eosin staining and light microscopy. Dura showed many similarities between species in terms of composition. In all species, dura consisted of at least one fibrovascular layer, which contained collagen, fibroblasts, and blood vessels, and a dural border cell layer beneath the fibrovascular layer. Differences between species included the number of fibrovascular layers, fibroblast orientation, and dural thickness. Human dura was the thickest (564 μm) followed by equine (313 μm), bovine (311 μm), and porcine (304 μm) dura. Given the results of this study and factors such as gross anatomy, feasibility, housing, and ethical considerations, we recommend the use of a porcine model for dural research, especially for in vivo studies.
Topics: Anatomy, Comparative; Animals; Animals, Laboratory; Dura Mater; Female; Humans; Male
PubMed: 32014084
DOI: 10.30802/AALAS-CM-19-000022 -
Proceedings of the National Academy of... Jan 2021Almost 150 papers about brain lymphatics have been published in the last 150 years. Recently, the information in these papers has been synthesized into a picture of...
Almost 150 papers about brain lymphatics have been published in the last 150 years. Recently, the information in these papers has been synthesized into a picture of central nervous system (CNS) "glymphatics," but the fine structure of lymphatic elements in the human brain based on imaging specific markers of lymphatic endothelium has not been described. We used LYVE1 and PDPN antibodies to visualize lymphatic marker-positive cells (LMPCs) in postmortem human brain samples, meninges, cavernous sinus (cavum trigeminale), and cranial nerves and bolstered our findings with a VEGFR3 antibody. LMPCs were present in the perivascular space, the walls of small and large arteries and veins, the media of large vessels along smooth muscle cell membranes, and the vascular adventitia. Lymphatic marker staining was detected in the pia mater, in the arachnoid, in venous sinuses, and among the layers of the dura mater. There were many LMPCs in the perineurium and endoneurium of cranial nerves. Soluble waste may move from the brain parenchyma via perivascular and paravascular routes to the closest subarachnoid space and then travel along the dura mater and/or cranial nerves. Particulate waste products travel along the laminae of the dura mater toward the jugular fossa, lamina cribrosa, and perineurium of the cranial nerves to enter the cervical lymphatics. CD3-positive T cells appear to be in close proximity to LMPCs in perivascular/perineural spaces throughout the brain. Both immunostaining and qPCR confirmed the presence of adhesion molecules in the CNS known to be involved in T cell migration.
Topics: Aged; Aged, 80 and over; Antibodies; Autopsy; Brain; Cell Movement; Central Nervous System; Dura Mater; Endothelium, Lymphatic; Female; Glymphatic System; Humans; Immunohistochemistry; Lymphatic System; Lymphatic Vessels; Male; Membrane Glycoproteins; Subarachnoid Space; T-Lymphocytes; Vascular Endothelial Growth Factor Receptor-3; Vesicular Transport Proteins
PubMed: 33446503
DOI: 10.1073/pnas.2002574118